BEGINNing therapy

When I work with a client I focus on the strengths that the individual already has or is trying to develop. My primary questions to my clients are:

Are you being true to yourself?

Are there conflicts holding you back from the person you want to be or you want to become?

Are you realistic about your goals?

What can you change to move closer to your ambitions and achieve your purposes in life?

Are your actions, behaviors, thoughts, feelings, values, and beliefs in agreement? If not, how can you change that?

Can I assist you in achieving your goals? How do we begin?

With that backdrop in mind, I will explore the possibilities and help you build the road to mental (and physical) wellness within the realistic and practical limits that life places before us.

Wholeness does not mean happiness and contentment all of the time—wholeness means learning how to live with and integrate all of life's events—ups and downs—and integrating our strengths and weaknesses—but that does not restrict us from changing aspects of ourselves and our lives.

My theoretical orientation to counseling is grounded in person-centered, existential, cognitive-behavioral, and strength-based methods. I am a current member of the American Counseling Association and the Nebraska Counseling Association. I have been affiliated with both organizations since 2009.

What happens in a typical counseling session?

No two counseling sessions are alike. No two counselors do things exactly the same way. No two clients are exactly alike. There are significant similarities, however.

Your first session typically takes one and a half hours. There are a number of forms that need to be filled out before we get started. The paperwork is a necessary part of the treatment. I will help you answer any questions you may have about it. After a few sessions I may create a specific treatment plan for you.

How often will we meet?

Depending on your needs and the reasons that brought you into the office, we may meet from up to two or three times per week to once a month. Typically, in the beginning I meet with clients one to two times per week unless it’s clear from the beginning that we need to alter that pattern. Generally, an appointment lasts one hour.

How will I know when I have completed my treatment?

This is a question where I take most of my direction from you. We will discuss it as we move along. Some clients are ready after just a few sessions. More often I am more comfortable if we meet for a couple of months or more and then determine how to proceed. Many times, we will meet less often as you progress.

If I seek counseling, does that mean I am mentally ill or crazy?

“Crazy” is a judgmental term that’s not helpful or descriptive. We all say the word at one time or another to express our feelings or beliefs about a situation or a person—maybe even ourselves—but it is not a word that is used in any serious discussion about mental health counseling. Most of us are fortunate enough not to suffer from a serious mental illness. That does not mean that we may not benefit from meeting with a counselor at some point in our lives.

What if I am experiencing particular problems but I don’t know if it is a mental disorder?

Note that this question uses the term “disorder,” not “illness.” Counselors rely on the latest Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) to classify disorders for insurance, statistical, or diagnostic purposes. We counselors may use the terms “disorder” or “illness” interchangeably on occasion, but the DSM-5 uses the term “disorder.”

Any of the reasons or problems that bring us to counseling may be defined or categorized in the DSM-5 in one form or another as a “disorder” and counselors routinely use the DSM-5 to classify the reason a person is seeking counseling as explained above.

What if I suspect or I know from my personal history that I may suffer from a serious mental disorder?

If you do suffer from a serious mental disorder and are having troubles coping with, treating, or managing it, please call for an appointment to discuss your options. Some mental disorders may require medical interventions as well as counseling. In some cases, an individual may need hospitalization or treatment in an inpatient setting. I refer my clients who need that level of assistance to the appropriate level of care.

Even so, if an individual needs medical care or needs daily mental care in an outpatient facility for a mental disorder, these persons may still benefit from meeting with a mental health counselor in addition to their medical or institutional care. If you believe you may be in this category, you and I can discuss your needs in consultation with the other professionals from whom you get treatment to determine how I can help you in your treatment and successful recovery or management of your symptoms.

Will anyone find out that I am seeking counseling or will they learn what I said to my counselor?

Counselors are bound by legal, ethical, and training standards to keep any information about a client in total confidence. No one will find out any information about your counseling, unless you choose to let someone know. Even if you sign a release stating that I can discuss your situation with someone else, I will rely on you for direction.

Here are the exceptions to the rule mentioned above.

If you wish to have your counseling services paid for through your health insurance or under your insurance deductible, I will be required to release very basic information about my services on your behalf to the insurance company. Details of your situation are not released. If insurance were to require more information than the basic information, I will discuss with you what I will release. Insurance companies are bound by legal standards also.

If you tell me that you have abused a child or a vulnerable adult or if you have presented evidence to me of the same, I am required by law and ethical standards to release the information to law enforcement.

If you tell me that you plan to hurt or injure someone or commit an illegal act or present evidence to me of the same, I am required by law and ethical standards to warn the person and to follow up with law enforcement.

If you state that you plan to harm yourself or you present evidence to me of the same, I am required by law and ethical standards to report it to appropriate law and health authorities.

I may occasionally confer with another counselor regarding the symptoms that you, as a client, may experience so that I may enhance my approach to your situation. In such cases I will not discuss or release any particular identifying information about you and my discussion will be related solely to your clinical symptoms.

I am required to release any information that a court of law requests from me for any legal purpose determined by the court. If I am called to testify in a court of law, I am bound by law to testify as to my personal knowledge of questions asked of me in court. I will not offer testimony in any legal proceeding as an expert or expert witness.